Glossary
Terms
A B C
D E F G
H I J K L M N
O P Q R
S T U V
W X Y Z
Closed Questions
Closed questions offer a set of appropriate answers
from which the interviewee can choose. For example: "Which of these
covers do you prefer, Cover #1 or Cover #2?"
Cognitive Interviewing
A cognitive interview is a special kind of interview
that focuses on how people absorb information, think about what they
see, and draw implications or conclusions.
Confidence Interval
A confidence interval refers to the statistical
likelihood that a score falls within a given range around an estimate.
This is important because nearly all health care quality scores are
developed using a statistical sampling method, which means that there is
some uncertainty about whether the sample reflects the population. The
confidence interval tells you how confident you can be that the score
for the sample represents the score for the entire membership or
population. For instance, a 99-percent confidence interval means that, if you
drew numerous samples, 99 percent of the estimates would fall within the given
range. A narrower range (e.g., a 90-percent confidence interval) would give you
less certainty about the estimate.
Cutpoint
A cutpoint is a statistical device for establishing
tiers of performance for a given measure or category. It is a point at
which you can say that those above that level are statistically
different from those below that level.
Distribution Brokers
Distribution brokers are organizations or people who
can serve as middlemen between you and your audience. Because of their
relationships and familiarity with your intended audience, distribution
brokers can be effective channels for delivering information to
consumers.
Distribution of Scores
A distribution of scores is essentially a picture of
the performance of competing health plans or providers. To create a
distribution, you would plot each health care organization’s score for
a given measure (or category) on one axis of a chart and the
organization’s identity on the other axis.
Focus Groups
A focus group is a special kind of group discussion
that is designed to elicit information about the wants, needs,
viewpoints, beliefs, and experiences of your intended audience. Focus
groups can help you better understand the expressions and terminology
commonly used by people in your audience, as well as their attitudes and
beliefs about health care. They are especially good at helping to
uncover the reason behind people’s responses.
Framing
Framing refers to the emotional tone of the message
you are communicating to consumers. For example, a positive frame would
accentuate the benefits of looking at and using information on quality,
while a negative frame would emphasize the risks of not doing so.
Gold Standard
A "gold standard" is a goal for health plan or provider
quality that reflects a high but achievable level of performance. The
purpose of setting a standard at this level is to encourage all players
in the market to reach beyond their current level of performance.
Health Maintenance Organization (HMO)
A Health Maintenance Organization (HMO) is a managed care organization that provides health care in return for pre-set monthly payments. Most HMOs provide care through a network of doctors, hospitals, and other medical professionals that their members must use in order to be covered for that care.
Information Intermediaries
Information intermediaries are people who can answer health care
consumers’ questions, address their concerns, and help them apply
information on health care quality to their personal situations –
whether face-to-face or over the telephone. In addition to providing a
more personal interpretation of data on quality, an information
intermediary can reinforce and supplement the information your audience
has.
Layering
Layering refers to a way of presenting data so that
the reader may look at information in both summary form and in detail.
This allows readers to focus on whatever level of information suits
their needs best.
Minimum Standard
A minimum standard is a level of quality that all
health plans (or providers) would be required to meet in order to offer
services to consumers.
Open-Ended Questions
An open-ended question allows a respondent to answer
in whatever way he or she chooses, using his or her own words. Unlike
closed questions, open-ended questions do not contain prompts for
specific responses from interviewees.
Open Enrollment
Open enrollment is a period of time during which
employees or beneficiaries can compare their health plan options (if
any) and choose which plan to enroll in for the coming year. This period
often takes place in the fall for an enrollment year that begins in
January, but it could occur at any time.
POS Plans
Point-of-service (POS) plans function like health maintenance organizations (HMOs) but allow
patients to seek care outside the plan’s network of doctors for an
additional cost.
PPO Plans
A preferred provider organization (PPO) is a health
care delivery system that controls costs by steering patients into more
affordable medical settings. PPOs do this by negotiating provider
discounts, encouraging preventive measures, implementing utilization
management programs, and developing networks of doctors and hospitals.
In return for offering medical services at negotiated reimbursement
levels, these doctors and hospitals get access to more patients and/or
more timely payments. Enrollees may use any provider in the PPO or
outside of the PPO, but have a financial incentivefor example, lower
coinsurance paymentsto use providers within the PPO.
Provider Groups
A provider group refers to any combination of provider
organizations (such as hospitals, medical groups, nursing homes, and
tertiary facilities) that contract with each other to jointly seek out
contracts with insurance companies and purchasers and to coordinate the
delivery of care for their patients.
RFP or Request for Proposal
A request for proposal (RFP) is a written document
requesting specific information from any parties wishing to compete for
a contract. Large purchasers may issue RFPs to learn more about the
quality and performance of health plans.
Sampling Error
Sampling error refers to the level of uncertainty
surrounding a data point that is drawn from a sample of the relevant
population.
Secondary Audience
A secondary audience is any group of people that may
influence the decisions of the primary audience by providing assistance
or advice. For example, secondary audiences for information on Medicare
plans would include the adult children of seniors and the insurance
counseling services available around the country.
Standardizing Scales
Quality measures are not necessarily based on the same
scales (e.g., they may be based on a scale of 0 to 5, or 1 to
100). The standardizing of scales refers to the statistical process of
converting or transforming scales to make them equivalent, which then
allows you to make statistically valid comparisons or combinations of
measures.
Statistical Significance
Statistical significance tells you whether two scores
are really different from each other. One way to determine statistical
significance is to check whether the confidence intervals around the
scores overlap.
Summary Score/Composite Score
Summary scores, also referred to as composite scores
in the context of CAHPS®, are a device for reporting health care quality
information as concisely as possible by condensing a number of quality
measures into a single piece of information. For example, rather than
report scores for five preventive care measures, a sponsor could report
one summary score for "Preventive Care" that reflects
performance on all five measures.
Usability Testing
Usability testing refers to the process involved in
learning whether and how consumers actually use your materials, what may
be preventing them from doing so, and what could help them.
Weighting
Weighting refers to emphasizing some measures more
than others when you combine individual results to create summary
scores. For example, if you were to combine four measures into a single
category, you could weight them equally (25 percent each). However, you may not
believe that those measures are equally important (two of
the measures reflect the experiences of all enrollees while the other
two are pertinent to only a small segment of enrollees). In that case,
you may want to give more weight to the first two measures (e.g., 35 percent
and 40 percent) and less weight to the remaining two (10 percent and 15 percent).
Research Organizations
A B
C D E F
G H I J
K L M N
O P Q R
S T U V W X
Y Z
Agency for Healthcare Research and Quality (AHRQ),
formerly the Agency for Health Care Policy and Research (AHCPR)
URL:
http://www.ahrq.gov
Phone: (301) 594-6662
The Agency for Healthcare Research and Quality is a
subordinate agency of the U.S. Department of Health and Human Services.
The primary function of AHRQ is to support research regarding the
improvement of health care in multiple areas. AHRQ-sponsored research
focuses on improving the outcomes and quality of health care, reducing
its costs, addressing patient safety and medical errors, and broadening
access to effective services. AHRQ also develops and distributes
information designed to help people make better health care decisions.
American Society on Aging (ASA)
URL:
http://www.asaging.org/ASA_Home_New5.cfm
Phone: (415) 974-9600
The American Society on Aging is an association of
researchers, doctors, educators, business people, and policymakers
interested in learning about the physical, emotional, economic, and
social facets of aging. ASA carries out its mission through Web-enhanced
teleconferences, computer-based training, and searchable databases that
provide a consolidated source of education and training resources. ASA
provides members with the opportunity to join Constituent Groups that
provide specialized newsletters, membership directories, and annual
programming in a particular area of interest.
Buyers Health Care Action Group (BHCAG)
URL:
http://www.bhcag.com
Phone: (952) 896-5186
Established in 1988, the Buyers Health Care Action
Group (BHCAG) is a strong coalition of 52 health care purchasers based
in Minnesota and South Dakota. Most members and associate members are
large, private employers; the State of Minnesota Department of Employee
Relations (DoER), which represents 150,000 State employees and their
dependents, is an associate member. Since 1997, BHCAG has sponsored an
innovative purchasing initiative that combines financial incentives with
information on quality and costs to help employees of participating
members choose among competing provider-based "care systems,"
rather than insurer-based health plans. Through written materials,
touch-screen kiosks, and the Internet, these employees and their
dependents have access to descriptive information about each care system
as well as scores based on patients’ reports of their experiences with
the care systems.
California Cooperative Healthcare Reporting Initiative (CCHRI)
Phone: (415) 281-8660
Conceived in 1994, the California Cooperative
Healthcare Reporting Initiative (CCHRI) is a collaboration of
purchasers, health plans, and providers dedicated to giving California’s
consumers important information about health plans. CCHRI is governed by
an executive committee consisting of 15 elected representatives (five
each from participating health plans, purchasers, and providers) that
meets monthly. The Pacific Business Group on Health (PBGH), a coalition
of large purchasers, is responsible for administering the program.
California HealthCare Foundation (CHCF)
URL:
http://www.chcf.org
Phone: (510) 238-1040
The California HealthCare Foundation is a private,
grant-making organization with the primary goals of increasing access to
health care for underserved people and bettering the general health
status of Californians. The CHCF accomplishes its goals in three ways:
foundation-initiated projects, request-for-proposal projects, and
projects initiated by unsolicited proposals.
California Public Employees’ Retirement System (CalPERS)
URL:
http://www.calpers.ca.gov
Phone: (916) 326-3000
The California Public Employees’ Retirement System is an agency
within the California State government responsible for providing
retirement and health benefits to 1.2 million California public
employees, retirees, and their families. The CalPERS health benefits
program offers members and contracting employers access to 10 health maintenance organizations (HMOs), two
preferred provider organizations (PPOs), and four special PPOs for
members who belong to specific employee associations. In addition to its
own initiatives to improve quality of care, CalPERS also participates in
the quality measurement and improvement activities of the Pacific
Business Group on Health.
Center for the Study of Services (Consumers’ Checkbook)
URL:
http://www.checkbook.org
Phone: (202) 347-7283
The Center for the Study of Services (CSS) is an
independent, nonprofit consumer organization founded in 1974 with
support from the U.S. Office of Consumer Affairs. The main purpose of
CSS is to provide consumers with information they can use to find high-quality services and products at the best possible prices. It is now
supported entirely by subscription payments, donations from individual
consumers, and fees for information services and books. Consumers’
Checkbook provides National information as well as local information for
Chicago, San Francisco, and Washington, DC.
Centers for Medicare & Medicaid Services (CMS), formerly Health Care Financing Administration (HCFA)
URL: http://www.cms.hhs.gov
Phone: (410) 786-3000
The Centers for Medicare & Medicaid Services is a
subordinate agency of the U.S. Department of Health and Human Services.
CMS is responsible for Federal health insurance programs, including
administration of the Medicare and Medicaid programs, which cover more
than 70 million Americans. CMS spends over $360 billion a year
buying health care services for beneficiaries of Medicare, Medicaid, and
the State Children’s Health Insurance Program.
Colorado Business Group on Health
URL:
http://www.coloradohealthonline.com/main.htm
Phone: (303) 922-0939
The Colorado Business Group on Health is a private,
non-profit coalition of private and public sector companies that provide
health care benefits to over 250,000 employees, retirees, and their
families. The CBGH advocates employer-led activity to promote value in
health care purchasing in Colorado.
Commonwealth Fund
URL:
http://www.cmwf.org
Phone: (212) 606-3800
The Commonwealth Fund is a private foundation
established in 1918 with the general objective of improving human
welfare. The Fund supports independent research on health and social
concerns and provides grants for projects that aim to improve health
care practice and policy. In particular, the Fund is dedicated to
improving care for vulnerable populations (such as children, the
elderly, low-income families, and minority Americans) and helping the
general populace become more informed about their health care.
Community Service Society of New York (CSSNY)
URL: http://www.cssny.org
Phone: (212) 254-8900
The Community Service Society of New York is a
private, nonprofit social service organization that aims to help poor
residents of New York City by doing work in the areas of income
maintenance, health care, affordable housing, and education. CSSNY’s
efforts in the health care arena are primarily in the form of research,
education, policy analysis, and advocacy.
Consumer Assessment of Health Plans (CAHPS®)
URL:
http://www.CAHPS-sun.org
Phone: 800-492-9261
The Consumer Assessment of Health Plans (CAHPS®) is a
research project funded by the Agency for Healthcare Research and
Quality (AHRQ) and in part by the Centers for Medicare & Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA). Commercial and public purchasers, health plans, and purchasing
coalitions can use the CAHPS® survey and reporting kit to gather and disseminate
comparable information on health care quality from the patient’s
perspective. The CAHPS® toolkit includes standardized surveys for
different kinds of enrollees, an analysis program, and templates for
reporting findings to consumers. CAHPS® was developed by a consortium
composed of Harvard University Medical School, RAND, the Research
Triangle Institute (RTI), and Westat. Westat is responsible for
providing technical assistance to users and also provides support to the
CAHPS® Consortium.
Consumer Reports
URL: http://www.consumerreports.org/main/home.jsp
Phone: (914) 378-2000
Consumer Reports is a
publication of the Consumers Union, an independent, nonprofit testing
and information organization. The broad objective of the Consumers Union
is to test products, inform the public, and ultimately protect
consumers. The Consumers Union does not accept advertisements in Consumer
Reports; income is derived solely from the sale of Consumer
Reports (in print and online) and from neutral, noncommercial
contributions, grants, and fees. Consumer Reports is widely
available at public and many private libraries.
Coordinated Autos/UAW Reporting System (CARS)
The CARS project is a coordinated quality measurement
and reporting initiative sponsored by the three U.S. auto manufacturers
(General Motors, Ford, and Daimler-Chrysler), the United Auto Workers
Union (UAW), and the Greater Detroit Area Health Council (GDAHC), a
broad-based coalition of business, labor, hospitals, health plans, and
others in Southeast Michigan. The purpose of CARS was to develop a
common measurement methodology and presentation format for reporting
information to consumers on the performance of health plans. While each
sponsor still produces its own report card and open enrollment
materials, the categories for measures included in the report and the
presentation of information (e.g., language, graphics, rating system)
are now standardized.
Employers Healthcare Alliance Cooperative (The Alliance)
URL: http://www.alliancehealthcoop.com
Phone: (608) 276-6620
Based in Madison, Wisconsin, the Employers Healthcare
Alliance Cooperative represents more than 30 employers and 100,000
people in south central Wisconsin. The Alliance contracts directly on
behalf of its members with both care systems (clinics) and hospitals.
It evaluates each of these provider organizations by
collecting performance data and distributing summary-level and detailed
reports.
FACCT|ONE
URL:http://www.facct.org/measures/Develop/FACCTONE.htm
Phone: (503) 223-2228
Developed by the Foundation for Accountability,
FACCT|ONE is a survey tool designed to measure how well health care
organizations meet the needs of patients with chronic illnesses. So far,
FACCT|ONE concentrates on common services related to the care and
management of asthma, diabetes, and coronary artery disease. By focusing
on aspects of care that are generally overlooked in accountability
measures, FACCT|ONE allows purchasers, consumers, and oversight agencies
to assess the performance of health care systems with regards to people
with serious and frequent health care needs.
Federal Employees Health Benefits (FEHB)
URL: http://www.opm.gov/insure/health/index.htm
The Federal Employees Health Benefits Program is a
Federally sponsored health benefits program covering over nine million
Federal employees, retirees, former employees, family members, and
former spouses. Carriers in the FEHB program provide coverage to most
employees and retirees of the Federal Government and the Postal Service.
Foundation for Accountability (FACCT)
URL: http://www.facct.org
Phone: (503) 223-2228
The Foundation for Accountability is a nonprofit
organization with the objective of helping Americans make the best
possible health care decisions. The FACCT board of trustees is comprised
of representatives from consumer organizations and purchasers of health
care services and insurance, representing nearly 80 million
Americans. FACCT accomplishes its goals by creating tools that help
people understand and use quality information. This includes developing
consumer-focused quality measures, supporting public education about
health care quality, supporting efforts to gather and provide quality
information, and promoting health policies that empower and inform
consumers.
Health Plan Employer Data and Information Set (HEDIS®)
URL: http://www.ncqa.org/Pages/Programs/HEDIS/index.htm
Phone: NCQA (202) 955-3500
The Health Plan Employer Data and Information Set is a
list of about 60 standardized performance measures developed and maintained by the National
Committee for Quality Assurance (NCQA) in Washington, DC. The purpose of HEDIS® is
to ensure that purchasers and consumers have the information they need
to accurately compare the performance of managed health care plans.
HEDIS® combines quality measures of process, structure, and outcomes with
measures that reflect members’ reports and assessments of their
experiences with health plans. Currently, most health plans report their
HEDIS® results directly to NCQA as well as to their larger customers.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
URL: http://www.jcaho.org
Phone: (630) 792-5000
An independent, nonprofit organization, the Joint
Commission on Accreditation of Healthcare Organizations is the leading
accrediting and standards-setting body in health care. It evaluates and
accredits nearly 20,000 health care organizations and programs
in the United States. The main objective of the JCAHO is to promote
improvements in the safety and quality of care provided to the public.
Kaiser Family Foundation
URL: http://www.kff.org
Phone: (650) 854-9400
The Kaiser Family Foundation is an independent
philanthropic organization that focuses on major health care issues
facing the United States. The Foundation serves as a source of facts and
analysis for policymakers, the media, the health care community, and the
general public. It accomplishes this by developing and running its own
research and communications programs, often contracting with a variety
of outside individuals and organizations. The Foundation also makes a small
number of grants for unsolicited proposals every year.
Managed Health Care Association (MHCA)
URL: http://www.emhca.org
Phone: (202) 218-4121
The Employers' Managed Health Care Association is a
league of National, private-sector employers that come together to share
their experiences as purchasers and promote learning about the value of
managed health care as a strategy for cost containment. The aim of the
MHCA is to advance a high-quality, cost-effective, consumer-focused
health care delivery system.
Medicaid
URL: http://www.cms.hhs.gov/medicaid/
Jointly funded by the Federal and State governments,
Medicaid assists States in providing adequate medical care for
individuals and families with low resources. Medicaid is the largest
program providing medical and health services to needy persons. Within
broad Federally established guidelines, every State sets its own
eligibility standards; determines the type, amount, and duration of
services; establishes the payment levels for services; and administers
its own program.
Medicare
URL: http://www.medicare.gov
Phone: 800-MEDICARE (633-4227) or
TTY/TDD: 1-(877) 486-2048 (hearing and speech impaired)
Medicare is the primary Federal health insurance
program for people 65 years of age and older, qualifying
disabled persons who are less than 65 years of age, and persons
with permanent kidney failure requiring dialysis or a transplant. The
two components of Medicare are Hospital Insurance (Part A) and Medical
Insurance (Part B), which covers visits to the doctor and other
services.
Medicare Rights Center (MRC)
URL: http://www.medicarerights.org/Index.html
Phone: (212) 869-3850
The Medicare Rights Center provides free counseling to
people with questions or concerns related to Medicare. Since it was
founded in 1989, the MRC has helped more than one million people with
Medicare-related issues. The MRC has conducted seminars and
presentations with several private and governmental organizations,
including the Department of Health and Human Services, AARP, and the
American Public Health Association.
National Adult Literacy Survey
URL: http://nces.ed.gov/naal/
Phone: (202) 502-7374
(Andrew Kolstad, Senior Technical Advisor, Assessment Division)
The National Adult Literacy Survey was implemented in
1992 by the National Center for Education Statistics (NCES) and the
Office of Vocational and Adult Education (OVAE). The survey represented
a comprehensive effort to measure the literacy levels of persons age
16 and over living in the United States in 1992. The data were
collected through household interviews in which respondents completed
written exercises that assessed their literacy skills. NCES will be
conducting this survey again in 2002.
National Association of Health Data Organizations (NAHDO)
URL: http://www.nahdo.org
Phone: (801) 587-9104
The National Association of Health Data Organizations
is an alliance of State, Federal, and private-sector policy leaders and
consultants. The main objective of NAHDO is to enhance the development
of health information systems and develop responsible health information
policies. To do this, NAHDO provides assistance with collection,
analysis, dissemination, public availability, and use of health data.
National CAHPS® Benchmarking Database (NCBD)
URL: http://ncbd.CAHPS.org
Phone: (651) 430-0759
The National CAHPS® Benchmarking Database is sponsored
by the Agency for Healthcare Research and Quality (AHRQ) and
administered through a partnership between Westat, the Quality
Measurement Advisory Service (QMAS), and The Picker Institute. The
primary purpose of the NCBD is to facilitate comparisons of CAHPS® results among various types of CAHPS® survey sponsors. The NCBD also
offers an important source of primary data for conducting specialized
research that will enable improvements in future CAHPS® survey design and
a better understanding of health plan and enrollee characteristics that
influence health care quality.
National Center for Education Statistics (NCES)
URL: http://nces.ed.gov
Phone: (202) 502-7300
The National Center for Education Statistics is a
subordinate agency of the U.S. Department of Education. The primary
function of the NCES is to collect and analyze data related to education
in the United States. Studies and other information are available at the
Web site.
National Committee for Quality Assurance (NCQA)
URL: http://www.ncqa.org
Phone: (202) 955-3500
The National Committee for Quality Assurance is an
independent, nonprofit organization that evaluates and reports on the
quality of managed care organizations in the United States. In addition
to developing HEDIS® and maintaining a database of results that is
updated each year (known as Quality Compass), the NCQA conducts an
extensive process to accredit health plans across the country. To date,
more than half of the Nation’s HMOs participate in the NCQA’s
voluntary accreditation program.
National Institute for Literacy (NIFL)
URL: http://novel.nifl.gov
Phone: (202) 233-2025
The National Institute for Literacy is a joint
government institute administered by the Secretaries of Labor,
Education, and Health and Human Services. The main objective of the NIFL
is to make sure that any persons with literacy deficiencies can access
services aimed at improving reading skills. The Institute acts as a
focal point for public and private actions that support regional, State,
and National literacy services.
National Opinion Research Center (NORC)
URL: http://www.norc.uchicago.edu
Phone: (773) 753-7500
The National Opinion Research Center is a nonprofit
organization associated with the University of Chicago. NORC conducts
surveys with the purpose of addressing critical issues facing government
agencies, private foundations, educational institutions, and private
companies. Many of the studies are used to form public policies, draft
laws, and determine how resources are allocated.
Office of Personnel Management (OPM)
URL: http://www.opm.gov
Phone: (202) 606-0815
The Office of Personnel Management is the human
resources agency of the Federal Government. OPM administers health benefits for Federal employees, manages the Federal
retirement system, supports agencies with staffing tools, and provides
guidance on labor-management relations, compensation policy development,
and curricula to improve workforce performance.
Pacific Business Group on Health (PBGH)
URL: http://www.pbgh.org
Phone: (415) 281-8660
The Pacific Business Group on Health is a nonprofit
coalition of 45 large employers that share a common goal of improving
the quality of health care while moderating costs. Most of the member
companies are in California and many have employees in multiple States.
Purchaser members of PBGH represent nearly three million employees,
retirees, and family members, accounting for three billion dollars in
annual health care expenditures.
Quality Measurement Advisory Service (QMAS)
URL: http://www.qmas.org
Phone: (206) 682-2811
The Quality Measurement Advisory Service is a program
of the nonprofit Foundation for Health Care Quality based in Seattle,
Washington. Initiated in 1996, QMAS assists local health care
coalitions, purchasing groups, and health information organizations in
measuring health care quality for purchasing and other purposes. QMAS
holds educational meetings, produces guides on quality measurement,
provides speaking and consulting services, manages collaborative
projects, and provides a means for exchanging information among its
affiliates.
RAND
URL: http://www.rand.org
Phone: (310) 393-0411
RAND is a California-based think tank with the mission
of improving policy and decisionmaking through research and analysis.
Researchers at RAND work on a variety of issues, assisting policymakers
at all levels, leaders in many private-sector industries, and the public
at large in efforts to improve the Nation's quality of life. RAND
analyzes choices and developments in many areas, including defense,
education, health care, criminal justice, labor, and community
development.
State Health Insurance Assistance Programs (SHIP)
URL: http://www.medicare.gov/contacts/related/ships.asp
Phone: Ask about the SHIP in your State by calling 800-MEDICARE
(633-4227) or TTY/TDD: (877) 486-2048 (hearing and speech
impaired).
With financial support from the Federal Government
(through the Centers for Medicare & Medicaid Services), the State Health
Insurance Assistance Programs are State-run programs designed to provide
free health insurance counseling and assistance for
Medicare beneficiaries.
|